/ 29 August 2012

TAC voices Tara KLamp circumcision concerns

The KwaZulu-Natal health department has rejected the Treatment Action Campaign's concerns over a device used to perform male circumcisions.
The KwaZulu-Natal health department has rejected the Treatment Action Campaign's concerns over a device used to perform male circumcisions.

Since 2010 a total of 175 927 men were circumcised. Of these, 35 989 were circumcised using the Tara KLamp (TK) and there had been no problems, provincial health minister Sibongiseni Dhlomo told reporters in Pietermaritzburg on Wednesday.

He was responding to the TAC's asking the public protector to investigate the TK's procurement and ongoing use.

The plastic device is clamped over the foreskin of a man's penis for seven to 10 days until the foreskin falls off. According to the TAC the device sometimes had to be surgically removed. "We can proudly report that using the TK we have observed that there were no deaths, no penile amputations, no permanent erectile dysfunctions and no permanent penile disfigurement," Dhlomo said.

TAC provincial chairperson Patrick Mdletshe said it was a dangerous device. "It has specifically not been approved by the World Health Organisation because it failed in the only clinical trial conducted to test its safety."

Head of department Dr Sibongile Zungu said a report guided by the WHO did not recommend the use of a device for circumcision. "The device is only suitable if you want to do a massive circumcision," Zungu said.

Large-scale circumcisions
Dhlomo said Africa wanted large-scale circumcisions. About three million people needed to be circumcised in the province. He dismissed the TAC's claims that the TK was more expensive compared to the standard surgical method. "The department has also observed that it is cheaper to both the client and the department to circumcise with the TK than the forceps, because the time spent on the client is very little.

"The client makes two visits to the hospital as opposed to four visits when using the forceps guided method [the standard surgical method]." Dhlomo criticised the TAC for comparing the use of the TK in the province with trials held in Orange Farm, Gauteng, saying this was misleading and dangerous.

According to the TAC, trials of the TK on adults in Orange Farm revealed a 32% infection rate, compared to 0% with the forceps. The complication rate when using the TK was 37% compared to 3% when forceps were used.

"We did not use the TK in KwaZulu-Natal without being trained on it. There was no training on the use of the device in Orange Farm," Dhlomo said.

The TAC complained that the TK was painful. Dhlomo said the department did not promise clients that there would be no pain. Dhlomo said the TAC was silent about challenges of medical male circumcision in parts of the country where people had died, but was focusing on KwaZulu-Natal where there had been no deaths, only medical pain.

"There is no reason for the department of health to stop using the TK and shall not stop it," Dhlomo said. – Sapa